Should I see a doctor: Osteoarthritis & rheumatoid arthritis

Some aches and pains are expected as you age, but what does it mean if your wrists or shoulders hurt constantly? Or if your ankles and knees need 30 minutes to “warm up” each morning? Or if you’re only in your 30s and your joints hurt more than they should?

It may be time to talk with your doctor or other health care provider about arthritis.

What’s ‘normal’

Any joint in the body is susceptible to wear and tear as part of the natural progression of life. Certain congenital conditions, such as hip dysplasia, or joint damage from earlier in life, may speed up that process.

For many people, this wear and tear leads to osteoarthritis, a chronic condition in which the cartilage that cushions the ends of each bone breaks down. It’s the most common type of arthritis.

Some people may find the pain mild enough to treat at home with over-the-counter options like acetaminophen (Tylenol), ibuprofen, topicals or heating pads. But prolonged Tylenol and ibuprofen use isn’t recommended, so it’s important to talk with your provider about long-term options.

Rheumatoid arthritis (RA) is another type of arthritis. It usually affects multiple joints, often on both sides of the body at the same time — for example, both hands or both knees. Joints may become swollen, red and warm to the touch. Many people also notice significant stiffness in the morning that can last for an hour or more.

RA is a chronic autoimmune disease, meaning the body’s immune system — typically designed to protect you from infections — mistakenly attacks healthy tissue in your joints, causing inflammation and damage to the joint lining. Unlike osteoarthritis, which develops during the aging process, risk factors for RA include a family history of RA, smoking and being assigned female at birth (women are more likely to develop RA than men).

Much like osteoarthritis, RA can range from mild to severe, with pain that can negatively impact your quality of life. Over-the-counter anti-inflammatories like ibuprofen may work on an as-needed basis, but shouldn’t be used long term.

Many people live with osteoarthritis for years before needing medical attention. However, it’s important to know red flags to look out for and to keep your primary care provider current on your condition to keep it from becoming unmanageable.

If you think RA may be the cause of your symptoms, see your primary care provider as soon as possible to determine if you need a referral to a rheumatologist. Sometimes appointment wait times can be long, so getting the process started early is helpful. If RA is diagnosed, starting treatment sooner can reduce your risk for joint damage and deformity.

What’s ‘not normal’

Don’t let the pain and discomfort of either osteoarthritis or RA interfere with everyday activities or damage your quality of life — this should not be your “new normal.” Talk with your primary care provider as soon as possible. Fully eliminating symptoms may take a while, be challenging or, in some cases, not completely possible, but you can take actions to reduce their impact.

Red-flag symptoms to look out for and seek immediate care for include:

• Signs of a septic joint, which include sudden, severe pain in a single joint, along with redness, swelling and warmth around the joint, often accompanied by difficulty moving the joint or a fever
• Signs of a stomach ulcer, such as burning stomach pain and indigestion after eating, due to prolonged over-the-counter medication use
• Night sweats or weight loss accompanying joint pain
• Numbness or weakness in or around painful joints

How to care for your condition

For both osteoarthritis and RA, the number-one phrase to remember is “motion is lotion.” As backward as it may seem, regular physical activity can help reduce joint pain and improve function.

While that may be challenging or impossible for some, providers recommend as much activity as possible. A short walk, stretching, swimming or working with a physical therapist are low-impact but effective options to keep moving. Additionally, maintaining a healthy weight may lessen pressure on joints.

For people with osteoarthritis who are no longer finding relief with at-home remedies, your provider may suggest physical therapy, steroid injections, braces, prescription medication or, eventually, surgery. Finding the right time for surgery can be tricky — having it too young runs the risk of you needing another joint replacement in the future, and too late in life may increase the risk for surgical complications.

People with RA may expect a longer road to treatment and symptom relief. RA is usually diagnosed when joint pain and swelling have lasted several weeks or longer. Your provider will also check to make sure your symptoms aren’t caused by other conditions, such as gout, infections, or other autoimmune diseases like lupus or psoriatic arthritis.

Your primary care provider may start with anti-inflammatory medications, such as steroids, to help control symptoms early on. Trying a Mediterranean diet — rich in fruits, vegetables, whole grains, fish and olive oil — may also help reduce inflammation in the body.

For long-term management, your rheumatologist will discuss medications called DMARDs (disease-modifying antirheumatic drugs), which work by calming your overactive immune system to protect your joints from damage.

Medical review provided for this piece by Maya Swaminathan, MD, MultiCare Rheumatology Specialists – Auburn and David Pommer, MD, MultiCare Primary Care – Selah.